This five year cross-national study of oral health status (ICS II) builds on an earlier (1973-1981) WHO investigation of 10 countries (ICS I). ICS II will provide new information on the relative contributions of socioenvironmental, delivery system and personal lifestyle factors to oral health status and the costs of care. The results are expected to offer major insights into the development of more effective and efficient strategies for improving oral health. Seven industrialized and three middle-income developing countries and the U.S. Indian Health Service will participate in the project. From one administrative region in each country, a random sample of 4,000 subjects will be selected, divided equally among four age groups (6-7, 12-13, 35-44, and 65-74 years). A sample of providers and health care administrators also will be identified. Using trained clinical examiners and pretested instruments, data will be obtained on oral health attitudes, beliefs, and practices, quality of care, utilization of services, oral health status and the costs of care. Data will be collected on different delivery system structures, for both personal dental services and community preventive programs. The project will be administered centrally from WHO. Technical and scientific coordination will be subcontracted to Columbia University. The actual collection of data will be the responsibility of research teams from the 10 countries. Project policy and general direction will be provided by a WHO appointed committee of nine internationally recognized dental scientists. Funding is requested to support the Indian Health Service's contribution to the central research budget. Except as otherwise negotiated, each country will be responsible for the resources needed to collect and analyze its own data.